Society faces a grave dilemma as it navigates the maze of hopelessness: suicide, a complex aspect of mental illness. When people struggle in the dark with invisible burdens, it is crucial to have a conversation that goes beyond sensationalism.

Let’s aim to disentangle it and reveal the many strands that together form the complicated entirety of this problem. Suicide attempts particularly among the youth, all too frequently end up as family secrets that are not looked into or handled in a way that could spare others from suffering the same fate.

According to the World Health Organisation (WHO), over 700,000 individuals die by suicide each year. Suicide ranks as the fourth most common cause of death for people aged 15 to 29. In low and middle-income nations, suicide rates account for 77 per cent of all suicides worldwide.

According to WHO figures, there were 19,331 suicide deaths in 2019 in Pakistan (4,560 females and 14,771 males). It is also estimated that there are at least 10–20 instances of self-harm for every suicide. Hence, there may be an estimated 140,000–300,000 acts of self-harm in Pakistan annually. Statistics, therefore, provide only a sliver of insight into suicide in Pakistan.

WHO says over 19,000 Pakistani nationals died by suicide in 2019

Due to societal stigma and legal complications surrounding the subject, diagnosing and treating suicidal thoughts is typically challenging.

“I am writing this note, Maa. I loved this world but I am dying because I don’t want to live in this boarding anymore. Don’t cry after my death and please don’t send my younger siblings to boarding. Please read my diary that I left in my cupboard,” wrote a 7th-grade student living in a boarding before committing suicide.

A mysterious increase has been witnessed in suicide cases across Pakistan in the last couple of years. The relatively recent death by suicide of the son of a religious scholar also sent shockwaves across the country.

It can be quite challenging to distinguish fact from fiction when it comes to suicide because there is a deluge of conflicting information. Being aware of the realities can enable us to assist people around us in ways that could save their lives. It’s a need of the hour to dismantle myths to bring a more empathetic and compassionate understanding towards suicide.

Suicidal thoughts and attempts are often interpreted by many in Pakistan, as an indication that one is not following the teachings of religion. Some interpret it as a sign of serious misdeeds, meaning they must have sinned and are now facing God’s wrath. The fact is that “They are patients, not sinners”.

One of the widespread misunderstandings regarding suicide is that you might incite someone to commit suicide by mentioning it. However, the truth is “say suicide to stop suicide”, as quoted by Dan Finke. Individuals who attempt suicide are frequently portrayed as weak. In actuality, they are going through such agony, that they just want to end their misery. It is also believed that suicide happens without any warning signs.

According to the Western Michigan University Suicide Prevention Programme, there are around 25 attempts for every suicide death. The idea that there is a particular profile for someone who could try suicide, including gender, age, race, socioeconomic status and educational attainment is another widespread fallacy. It’s quite evident from recent alleged suicide cases in Pakistan that anyone can be affected by it, regardless of circumstances.

“It is not feasible to halt suicide,” another commonly established myth. It can be prevented, however; initiatives are needed at all levels of society.

A major obstacle is the stigma attached to mental health issues. Misconceptions about suicide often cause people to mask their problems due to fear of being judged. This resistance to asking for help might seriously obstruct early intervention. Unaffordable mental health services serve as another barrier, especially in underprivileged areas. There are only 0.19 psychiatrists per 100,000 inhabitants, hence, showing a lack of mental health professionals in Pakistan. The total budget allocated to health in Pakistan is roughly 2pc, out of which only 0.5pc is assigned for mental health.

Suicidal ideation is not always obvious, and people may not express their anguish. Enhanced knowledge, instruction, and training regarding risk factor identification can augment the capacity of communities, households, and experts to detect and assist individuals requiring assistance. Protective variables lessen the likelihood of suicide and offset the risk variables related to mental health. Considering the close relationship between the mind and body, good sleep hygiene and physical exercise do improve overall well-being.

Research shows that social support, feeling loved, cared for, respected, and being a part of a social network fosters a sense of belonging and acts as a deterrent to suicide.

Everyone can contribute to the prevention of suicide. It is the need of the hour to understand that it is a collective business. Many countries like Iran, Japan and Namibia have established their National Policy on Suicide Prevention which has significantly reduced suicide rates in the respective countries.

It is high time to work on policymaking in Pakistan to work collaboratively at the national level. World Health Organisation has provided an extensive guideline “Live Life” for suicide prevention. The guideline entails the importance of early identification and management, limited access to means of suicide and substance use, and improving life skills of young adults which is the most at-risk group. By training media professionals and encouraging responsible reporting, media can also play a role.

To sum up, the critical responsibility of preventing suicide demands concerted action from societies and governments. Through tearing down the walls of stigma related to mental health, increasing accessibility to essential resources, and cultivating a community-based support network, we all need to work together to address the multifaceted issues that lead to suicide.

— The writer is a Professor of Psychiatry

Published in Dawn, February 19th, 2024